Infection Prevention Week: Infections in Nursing Homes

October 14-20 is International Infection Prevention Week, a week in which government and health-focused organizations push to educate both the public and professionals on infection prevention and risk factors, as well as identifying symptoms and treatment options.

The elderly are already vulnerable to infections due to weakened immune systems, but those residing in nursing homes and assisted-living facilities are even more so. Sharing close quarters makes the transmission of infections easier, compounded by the fact that elderly nursing home residents often have open wounds that serve as prime routes of entry for infections.

Infections are a major cause of hospitalization and death; as many as 380,000 people die of the infections in LTCFs every year.

Some of the common infections seen in long term care facilities are MRSA, C. Difficile, and other gastrointestinal viruses. Due to frequent use of catheters, the elderly are also at risk for Urinary Tract Infections (UTIs).

Potentially Fatal Infections in Nursing HomesWhile hand washing is considered the first line of defense against the transmission of infections, those living in nursing homes and using shared spaces, equipment and furniture are still at risk, even when healthcare providers and fellow residents adhere to strict hand washing protocol and equipment sterilization.

C. Difficile, referred to as C. Diff, can be fatal to the elderly. C. Diff causes nausea, watery diahrrea, and intense stomach pains. The diahrrea that accompanies C. Diff can quickly dehydrate a patient, causing the kidneys to work harder, as well as causing extreme dips in blood pressure.

MRSA, or Methicillin-Resistant Staphylococcus Aureus, is another bacterial infection commonly found in healthcare settings. In a long term care setting such as a nursing home, this staph infection can also wreak havoc on the health of an elderly patient. MRSA symptoms typically present on the skin as a series of red bumps that are usually hot to the touch, eventually turning into pus-filled boils as the infection advances. MRSA is more than a nuisance. This infection is notoriously hard to treat due to decades of over-prescribing antibiotics. Finding the right antibiotic to knock out the bacteria is a matter of trial and error and in the meantime, the infection can quickly spread throughout the body, working its way into a patient’s bloodstream and affecting not only bones and joints, but major organs as well.

Urinary Tract Infections, or UTIs, are more frequently found in nursing home residents with a catheter, although they can occur in those without one. The bacteria works its way through a patient’s urinary tract and if left untreated, into the bloodstream.

One major complication of an infection is something called sepsis. Sepsis is the body’s own response to fighting an infection and is not able to be caught from someone else or transmitted to another person. Sepsis sends chemicals throughout the blood, which causes potentially fatal inflammation that causes gastrointestinal issues, cognitive impairment and dizziness, and eventually organ failure and death. The mental impairment and dizziness potentially caused by sepsis makes it difficult to express pain, especially in those patients who are already suffering from dementia. This altered mental state can also lead to falls and other injuries.

Infants, the elderly and anyone with a weakened immune system due to illness are especially vulnerable to developing sepsis from an infection. Sepsis can develop from already infected bed sores, in those who already have MRSA, C. Diff, UTIs, pneumonia or other infections. Sepsis can essentially develop anytime there is already an infection in the body.

Prevention and Early Detection are KeyDr. Paula Lester, a geriatrician at Winthrop-University Hospital, in Mineola, N.Y. told Health Day in 2016 that because many nursing home residents suffer from dementia, the ability to express their discomfort and pain is often limited. This inability to express pain can make describing symptoms nearly impossible. Competent staff within nursing homes is crucial to ensuring that an early diagnosis is made and that treatment is given immediately.

The takeaway is that infection prevention in nursing homes is incredibly difficult, but certainly not impossible. Nursing homes should provide frequent and robust staff training on infection prevention techniques and infection management, including training on hand washing, equipment sterilization, identifying patients for isolation (to avoid the spread of transmissible infections) as well as on the rapid identification of symptoms and treatment methods.

Due to weakened immune systems naturally found in the elderly, along with other existing health factors and the underlying problem of antibiotic resistance, successful treatment of serious infections can also be difficult. Research has shown that adequate staffing is linked to fewer cases of infection in hospital patients. The same thinking is likely relevant to nursing homes. With adequate staff, nurses and nurse aides are less likely to rush, which leads to proper hand washing and sanitizing of medical equipment, as well as more time with the resident to identify symptoms of infection at their onset.

Nursing Home Infection AttorneysIf you suspect mistreatment of a serious infection of a nursing home resident as the cause of their illness or untimely death, please contact Levin & Perconti, one of the nation’s most recognized and respected leaders in the areas of elder abuse and nursing home negligence litigation.

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